HIFU - works?

In order to provide sensible comments, one would need to know details about your case.

HIFU can be a secondary treatment,  after a failed active treatment; as well as a primary treatment for a low volume disease

Old Salt's request for you to provide details of your case is valid.

MEtoAZ said:

I did some research into HIFU..

High Intensity Focused Ultra-sound has been around predominately outside the US for some time.  There are a couple of manufacturers that I know of; SonaBlade and Ablatherm, at least when I researched earlier this year.  They both have their pros and cons like anything else.  Cleveland Clinic in Canada uses the Albatherm so I figured that HIFU has to have some credibility for them to have the device.

I discussed this option with my urologist who didn't think it would ever be approved for general use in US because of the lack of trial success.  From my research, that has as much to do with the cumbersome trials and having to having parallel options for comparisons.

The lack of general acceptance in the US was the primary factor in my pursuing a different course (Cyberknife in my case) as I did not like the thought of spending $25K out of pocket to travel outside of country for treatment that was not covered by insurance and then having to follow-up with a local urologist after having a treatment that the urologist doesn't support.  Seemed like it could lead to a less than friendly doctor visit and a "I told you so" if anything went wrong.  My cost for treatment with CK was covered outside of the balance of my $3,500 medical deductible.

Aside from those drawbacks, from my research it seems to be reasonably respected, outside the US and is used extensively.  If you don't mind the travel, price and on-going maintenance with an unaffiliated doctor, it seems like an effective treatment for low grade, contained cancer with minimal prostate enlargement. 

You would also want the latest generation of the machines as they are continually updating the technology and the older machines are far less accurate than the newer versions as I seem to recall.  One other problem in US at least as of Feb 2016 when I was researching, the OLDER sonablate (450?) was approved for limited usage in US, but newer one (500?) was still waiting for approval even though it appeared to be a far superior device.

Like MEtoAZ, I looked into HiFU back when I was 1st diagnosed wPCa 6 years ago and found out pretty much what MEtoAZ did. 

Cost was around $25k, had to pay for it yourself (not covered by insurance), had to fly to Canada, Mexico or somewhere in the Carribean to get it done, had to pay for flight/lodgings for followup visits w/the attending physician in NYC or Florida (no local providers available to me) and (on top of that) the "pitch" for HiFU which just seemed like a scam to me.  So, I passed.